Evaluation of adherence to adrenaline auto-injector use and knowledge retention among c-KIT positive hymenoptera venom allergic patients

Abstract

Abstract Backround: Severe anaphylactic reactions in patients with clonal mast cell diseases highlight the importance of an adeptly utilization adrenaline auto-injectors (AI). This research aimed to evaluate the knowledge retention and adherence to AI usage among individuals with hymenoptera venom allergies and a c-KIT positive mutation, receiving venom immunotherapy (VIT) and equipped with two AI devices. Methods: 71 participants undergoing VIT received personalized education on AI utilization. Knowledge assessments were conducted at varying intervals: 3 months, 4-12 months, 12-24 months, and beyond 24 months post-education. Additionally, fifteen participants, having completed VIT five years prior, underwent re-education via video content, followed by a knowledge assessment one month post-retraining. Results: The findings highlighted significant differences in knowledge retention across intervals, emphasizing the need for tailored educational approaches. Participants assessed 'after 3 months' demonstrated higher knowledge levels (82.3%) compared to those 'after 12-24 months' (40.0%, p = 0.0160) and 'after 24 months' (22.2%, p = 0.0005). Prolonged post-training periods showed a decline in knowledge (-0.9362). Common AI usage errors included safety cap disregard (16.7%), inadequate force during thigh injection, potential finger injection, and device activation in the upper arm muscle (totaling 19.0%). Moreover, 19.8% failure to administer the AI in the muscle for the requisite 3 seconds, 27% were unaware of assuming a supine position during anaphylaxis, and 14.3% did not seek emergency assistance. In a separate group, 80% lacked AI proficiency after a month, with 73.3% unaware of the second AI administration, and 66.7% without their devices. Conclussion: This study underscores the critical necessity for continual, customized educational interventions to ensure proficient AI device utilization among individuals with specific venom allergies, particularly those with c-KIT positive status. Relying solely on video content for knowledge reinforcement may not yield optimal efficiency levels.